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Racial, ethnic disparities persist in Medicare Advantage

MA plans have been touted as giving more control over to seniors, but non-minorities may be reaping most of the benefits. (Image: CC BY 2.0 by jonrawlinson)

Minority groups, especially Hispanic and black patients, are receiving worse care under Medicare Advantage plans compared to whites, according to new data from the federal government.

An annual report (PDF) released this week by the Centers for Medicare & Medicaid Services (CMS) found that Hispanics received worse clinical care in 11 out of 27 quality measures, including diabetes care, initiation of drug treatment, and medication management, but better quality for six.

Similarly, blacks and African American received worse clinical care in eight measures, including controlling blood pressure, beta-blocker treatment after a heart attack, and follow-up after a hospital stay for mental illness, but better quality for three. Asians or Pacific Islanders received worse clinical care than whites for 3 measures, but better quality for 11.

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The agency released the report in recognition of National Minority Health Month to raise awareness of health disparities among different ethnic groups. The report has been released in previous years with similar results.

Medicare Advantage proponents say the plans allow seniors to choose plans that better align with their needs. Others say that socio-economic differences, such as education, between minorities and non-minorities create an imbalance.

Additionally, MA usage among minorities is underwhelming. While non-minorities make up about 61% of the U.S. population, according to the U.S. census, they comprise about 70% of all MA beneficiaries.

Philip Alberti, senior director of health equity research and policy at the Association of American Medical Colleges, told FierceHealthcare these racial issues transcend MA plans.

“The new report confirms what we have known about inequities in quality more broadly: for close to half of the indicators assessed, racial and ethnic minorities do not receive the same quality of care as their white counterparts, nor do they report the same overall level of satisfaction with the care they receive" he said. "The Agency for Healthcare Research and Quality has tracked similar measures for all Americans for over a decade with nearly identical results."

While the study did not compare disparities between MA plans and traditional Medicare, other research has found smaller disparities in the more socialized program.

More minorities with traditional Medicare tend to be readmitted to the hospital within a month after major surgery compared to non-minorities, however the racial disparity is even greater within Medicare Advantage, according to HealthAffairs.

Kata Kertesz and David Lipschutz, policy attorneys at the Center for Medicare Advocacy said the Medicare agency needs to do more to improve racial issues in the program.

"This underscores the need for more data and studies on these disparities," Lipschutz told FierceHealthcare. "We need more Medicare claims data to evaluate and fix this."

He added that the Trump administration, which has signaled it is open to more transparency in the healthcare system, would have to make such claims data available.